Treatment for Fecal Incontinence
What is the treatment for fecal incontinence?
Since the cause of fecal incontinence is different in every patient, the treatment for incontinence is also specific to each patient. Treatments may include changes in your diet, changes in your prescription medications, constipating medications such as loperamide (Immodium) or diphenoxylate/atropine (Lomotil), muscle strengthening exercises or biofeedback. Depending on the severity of your symptoms and for patients who continue to experience symptoms despite conservative measures, Dr. Zaghiyan may offer other treatments such as Solesta, sacral nerve stimulation (SNS), or sphincter repair.
Solesta is a gel made of natural materials called dextranomer and sodium hyaluronate. Performed as an office-based treatment, Dr. Zaghiyan will inject the Solesta in the anal canal. The Solesta then adds bulk to the anal canal to help control your bowels and gas. The procedure is very well tolerated, does not require anesthesia, and patients can resume limited activity immediately, and normal physical activity in 1 week.
Sacral nerve stimulation (SNS) or Interstim is FDA approved for fecal incontinence that has failed conservative therapy. The treatment targets the 3rd sacral nerve root, which controls bowel and bladder continence. The procedure is performed in 2 stages by a colorectal surgeon. Both stages are performed as outpatient surgery in the operating room. During the first stage, known as the trial assessment, your surgeon will place a thin, flexible wire, called a test lead, near your tailbone, which will send mild electrical pulses to the nerves that control your bowel continence. Your ability to control your bowels with the test lead will be tracked over the next several days. If Interstim has worked for you during the trial assessment, then the flexible wire or lead will be implanted under your skin permanently during the 2nd stage. SNS has been shown to improve quality of life, and reduce the frequency and severity of fecal incontinence episodes in the majority of patients who receive the permanent implant.
Sphincter repair or overlapping sphincteroplasty is an operation performed to restore your sphincter muscle anatomy if it has been damaged in childbirth, anal surgery, or other anal trauma. In this procedure, the two ends of the cut sphincter muscle are identified and reattached in an overlapping fashion to create more bulk and strength.
Call to make an appointment with Dr. Zaghiyan in her office in Los Angeles to have your symptoms evaluated and to learn which treatment is best for you.